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Audrea Prudence Doyle MRN-100746 · born 2004-11-10 ✦ AI Ask ✦ AI Ambient note Chart

Claim CLM-2026078003

Audrea Prudence Doyle MRN-100746 Payer Medicaid Service Sep 10, 2025 Status paid
$85.55
billed
$59.88
allowed
$0.00
paid
$59.88
patient responsibility

Adjudication lines

ServiceCodeBilled Paid
Encounter for symptom (procedure)185345009 $0.00 $0.00
Viral sinusitis (disorder)444814009 $0.00 $0.00